Relationship between nailfold capillary abnormalities and organ involvement in systemic sclerosis

Abstract

Nailfold capillary abnormalities in 42 consecutive patients with systemic sclerosis were studied by widefield capillary microscopy, and capillary abnormalities were correlated with organ involvement. Twenty-eight patients had diffuse skin disease, and 14 had the CREST variant of systemic sclerosis (calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, telangiectasias) with anticentromere antibodies. Nailfold capillary enlargement and loss were graded from photographs. There was no correlation between the severity of either nailfold capillary loss or enlargement and duration of disease, number of organ systems involved, or acroosteolysis. The presence of telangiectasias correlated with extreme capillary enlargement (P < 0.025). Based on these findings it can be concluded that nailfold capillary changes in individual patients with systemic sclerosis are not useful in predicting organ involvement.